Healthcare Provider Details
I. General information
NPI: 1982493771
Provider Name (Legal Business Name): 4HEARTS LEGACY LEARNING AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/06/2025
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
630 FOXFIELD RD
HOPKINSVILLE KY
42240-6110
US
IV. Provider business mailing address
630 FOXFIELD RD
HOPKINSVILLE KY
42240-6110
US
V. Phone/Fax
- Phone: 270-498-9843
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
ADIA
SNORTON
Title or Position: OWNER
Credential:
Phone: 270-498-9843